Among the most intractable issues we face as a society is how to identify and treat mental illness. Many Americans go through life with undiagnosed and untreated mental health conditions, and even those who’ve been properly diagnosed often have difficulty accessing appropriate treatment and support. The issue of mental health has a long and complicated political history, often treated like a hot potato being legislated back and forth between State and Federal governments. Presently, the responsibility to provide mental health services largely falls on States, with some financial support from the Federal government in the form of block grants, Medicaid, and Medicare.
Following the financial collapse of 2008, States facing serious budget shortfalls cut more than $4.35 billion in public mental health spending between 2009-2012. Unfortunately, the programs that remain are insufficient to serve the needs that exist, and people often can’t access the help they need. Many end up masking symptoms through drug and alcohol use; some ultimately find themselves homeless on the streets or in jail. Corrections officials across the country have been put in the difficult position of running defacto mental health facilities by virtue of the fact that there’s nowhere else for individuals experiencing a mental health crisis to go.
In Chicago, Sheriff Thomas Dart refers to the Cook County Jail as the largest mental institution in the country. Sheriff Dart is facing this problem head on, however, and in 2015 he took the unusual step of appointing a Psychologist, Nneka Jones Tapia, as the jail’s warden. Dr. Tapia has begun the process of treating inmates for any ongoing mental health conditions they suffer from. All inmates are given mental health screenings upon arrival at the jail (which is still surprisingly uncommon despite the high levels of mental illness in jails across the country), and medication is prescribed as appropriate. Dr. Tapia also helped create a mental health transition center where inmates are taught how to manage their behavior and maintain employment. Inmates are also enrolled in health care plans and referred to appropriate case management to continue treatment for their conditions once they are released.
Despite the ubiquity of mental illness in a system that lacks sufficient resources to properly address it, efforts like those of Sheriff Dart and Dr. Tapia should be encouraged, expanded, and replicated wherever possible.